A protocol for a randomised controlled trial of prefabricated versus customised foot orthoses for people with rheumatoid arthritis: the FOCOS RA trial [Foot Orthoses – Customised v Off-the-Shelf in Rheumatoid Arthritis]

Article


Gallagher, K., Godwin, Jon, Hendry, Gordon J., Steultjens, Martijn and Woodburn, Jim 2018. A protocol for a randomised controlled trial of prefabricated versus customised foot orthoses for people with rheumatoid arthritis: the FOCOS RA trial [Foot Orthoses – Customised v Off-the-Shelf in Rheumatoid Arthritis]. Journal of Foot and Ankle Research. 11 (24).
AuthorsGallagher, K., Godwin, Jon, Hendry, Gordon J., Steultjens, Martijn and Woodburn, Jim
Abstract

Background

Foot pain is common in rheumatoid arthritis and appears to persist despite modern day medical management. Several clinical practice guidelines currently recommend the use of foot orthoses for the treatment of foot pain in people with rheumatoid arthritis. However, an evidence gap currently exists concerning the comparative clinical- and cost-effectiveness of prefabricated and customised foot orthoses in people with early rheumatoid arthritis. Early intervention with orthotics may offer the best opportunity for positive therapeutic outcomes. The primary aim of this study is to evaluate the comparative clinical- and cost-effectiveness of prefabricated versus customised orthoses for reducing foot pain over 12 months.
Methods/design

This is a multi-centre two-arm parallel randomised controlled trial comparing prefabricated versus customised orthoses in participants with early rheumatoid arthritis (< 2 years disease duration). A total of 160 (a minimum of 80 randomised to each arm) eligible participants will be recruited from United Kingdom National Health Service Rheumatology Outpatient Clinics. The primary outcome will be foot pain measured via the Foot Function Index pain subscale at 12 months. Secondary outcomes will include foot related impairments and disability via the Foot Impact Scale for rheumatoid arthritis, global functional status via the Stanford Health Assessment Questionnaire, foot disease activity via the Rheumatoid Arthritis Foot Disease Activity Index, and health-related quality of life at baseline, 6 and 12 months. Process outcomes will include recruitment/retention rates, data completion rates, intervention adherence rates, and participant intervention and trial participation satisfaction. Cost-utility and cost-effectiveness analyses will be undertaken.
Discussion

Outcome measures collected at baseline, 6 and 12 months will be used to evaluate the comparative clinical- and cost- effectiveness of customised versus prefabricated orthoses for this treatment of early rheumatoid arthritis foot conditions. This trial will help to guide orthotic prescription recommendations for the management of foot pain for people with early rheumatoid arthritis in future.
Trial registration

ISRCTN13654421. Registered 09 February 2016.

JournalJournal of Foot and Ankle Research
Journal citation11 (24)
ISSN1757-1146
Year2018
PublisherBioMed Central for Australasian Podiatry Council and Society of Chiropodists and Podiatrists (UK)
Publisher's version
License
Digital Object Identifier (DOI)doi:10.1186/s13047-018-0272-3
Web address (URL)https://doi.org/10.1186/s13047-018-0272-3
Publication dates
Online31 May 2018
Publication process dates
Deposited21 Jun 2018
Accepted28 May 2018
Accepted28 May 2018
FunderDr. William M. Scholl Foundation
Copyright information© 2018 The authors
LicenseCC BY 4.0
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